RE: tip variant fsgs relapse in pregnancy 43 minutes ago

We usually do NOT recommend a re-biopsy in steroid responsive NS, pregnant or not. If in full relapse she should be treated with Steroid or CsA mon...

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RE: Pla2r positive MN 56 minutes ago

Understood- but the relapse rate is under 10% for spontaneous and > 25% for treatmdnt relatrd remussikns. This advantage of spontaneous remission a...

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RE: tip variant fsgs relapse in pregnancy 1 hour ago

How quickly did her prior episode of proteinuria remit on steroids? Need for repeat biopsy and choice of a short course of steroids vs prolonged CN...

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RE: Pla2r positive MN 3 hours ago

The spontaneous remission does occur. At 25% rate means that 3 out of 4 patients will not remit. To make decision about wait or not hinges on the r...

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RE: Peritoneal Dialysis PET test: Need for baseline? 4 hours ago

Thanks Swap, The overnight drain volume with the standard 2L 2.5% dianeal fill gives you a good idea whether you can use a 2.5% for the lo...

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tip variant fsgs relapse in pregnancy 4 hours ago

I am due to see my patient who had a tip variant fsgs and had went into complete remission on steroids in 2017/18. She emailed me from her holiday ...

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RE: Peritoneal Dialysis PET test: Need for baseline? 6 hours ago

I asked my PD expert colleague ( @Brendan Mccormick) and this is his input: "We still do baseline PETs (4.25%) and I find them useful for the foll...

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RE: Recurrent FSGS in Transplant 6 hours ago

I would strongly consider 2nd transplant ( DD if possible ) given young age of patient despite high risk of recurrence with prophylactic measures a...

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Peritoneal Dialysis PET test: Need for baseline? 7 hours ago

The ISPD recommends a PET in the first 6-12 weeks of starting PD. https://pubmed.ncbi.nlm.nih.gov/33563110/ "Guideline 2a: Identification of fa...

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RE: Recurrent FSGS in Transplant 8 hours ago

@Richard Glassock I am perplexed by your personal reluctance to accept the proven concept of the failure of transplant nephrectomy to diminished th...

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Applications Now Open for Kidney TREKS – A Week-Long Research Course and Longitudinal Mentorship Program 10 hours ago

Dear all, Applications are now open for the 2025 ASN Kidney TREKS (Tutored Research and Education for Kidney Scholars) Program. Kidney TREKS fost...

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Applications Now Open for the 2025 Kidney TREKS Program! 10 hours ago

Dear Kidney Educators, Please share the opportunity to apply to the ASN Kidney TREKS (Tutored Research and Education for Kidney Scholars) Program...

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RE: Appreciate Input in this case ESP 10 hours ago

Since the gut is still working, tamoxifen and prednisone trial. Thanks for the community support. ------------------------------ Sachin ---------...

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RE: Recurrent FSGS in Transplant 11 hours ago

Dr. Imane Beggah: It has been suggested (but not everyone agrees) that FSGS is more likely to recur if recipient and donor are highly HLA-matched, ...

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RE: Recurrent FSGS in Transplant 13 hours ago

However, retransplantation (using a deceased donor and avoiding a good HLA match which may decrease chance of recurrent FSGS) DR Venkat Can you el...

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RE: Collapsing Fsgs 15 hours ago

I assume you rule out Parvovirus B19 and CMV infections. Agree for genetic test to rule out APOL1 and other FSGS implicated genes giving his young...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 16 hours ago

This is odd for MCD to have this fulminant course or dialysis-dependence AKI and even this elderly man may have severe arterionephrosclerosis, but ...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 16 hours ago

No commercial test, but you could try the nephrology department of the University Hamburg. They have a test and are interested im samples. Autoan...

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RE: Recurrent FSGS in Transplant 16 hours ago

Daratumumab has success in case reports for treatment of rFSGS by possible targeting anti-Nephrin Abs (attached from last ASN). May be used prophy...

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RE: Fibronectin Glomerulopathy 18 hours ago

Three choices- 1) Conservative with RASi - I do not think that SGLT2i will be of much help. If the proteinuria falls by > 40% keep using RASi ind...

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RE: Fibronectin Glomerulopathy 19 hours ago

Many thanks Dr. Glassock for your help in solving the dilemma in this case. DNAJB9 tissue staining was positive. So what are your thoughts on treat...

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RE: Patient 19 hours ago

I appreciate your input Dr. Glassock. They were collected and the results are still pending. I will keep you posted. ---------------------------...

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RE: Recurrent FSGS in Transplant 21 hours ago

Thanks - very important consensus driven paper. Figure 1 on the incidence of " recurrent " FSGS is meaningless as it conflates all categories of FS...

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RE: Recurrent FSGS in Transplant 21 hours ago

I hope that the recently attached publication sheds some additional light in this case. ------------------------------ Mario Rubin, M.D. Hou...

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RE: Patient 22 hours ago

What is the Plasma and Urinary Osmolality? Do you have values for 24 hour Sodium, Potassium and Urea excretion? .The polyuria could be a combinatio...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 22 hours ago

There is no commercially available assay for anti-Nephrin antibody. I understand the issue of "no transplant" but I have been involved in kidney tr...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 23 hours ago

I'm going to see about sending his biopsy to Columbia (from upstate NY) for any clues to antibody mediated podocytopathy. This would help in decidi...

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Patient 1 day ago

Post obstructive diuresis: I have a 64 yr old male with obstructive uropathy who had a foley placed and is doing very well but his post obstru...

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RE: Recurrent FSGS in Transplant 1 day ago

Agree with the already made management suggestions and the pessimistic prediction regarding outcome of a second transplant in this patient. However...

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RE: Collapsing Fsgs 1 day ago

The clinical story is most compatible with Primary (permeability factor related ) FSGS, with feature of Collatsing Nephripoapy, I would probably do...

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RE: Recurrent FSGS in Transplant 1 day ago

Dr. Rubin's and Dr. Rodby's management strategies are both quite reasonable, although in diametrically opposite pathways. A genetic form of FSGS wo...

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Collapsing Fsgs 1 day ago

26 year-old a single male does not speak any English, truck driver by profession, with no history of alcohol drug abuse moved from Uzbekistan one y...

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RE: Recurrent FSGS in Transplant 1 day ago

Thank you Dr. Rodby for requesting my opinion about this difficult case. I fully agree with the assertions that this is most likely a case of FSGS ...

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RE: Re: autonomic dysreflexia 1 day ago

Thank you Dr Glassock It was thrombotic- If I remember correctly, I think it`s protein C deficiency- he is on anticoagulation I am planning to ...

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RE: Recurrent FSGS in Transplant 1 day ago

As nephrotic as he was this sure seems like permeability factor podocytopathy FSGS, unfortunately he was steroid unresponsive which does not bode w...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

Addendum- this patients has a very high risk of recurrent disease (FSGS) in a kidney allograft. Perhaps as high as 70%, especially if this is due t...

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RE: Recurrent FSGS in Transplant 1 day ago

Highly unlikely that this is Genetic FSGS. A second kidney transplant has a 90%+ likelihood of another recurrence with loss of graft- especially if...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

Thanks Dr. Glassock. This "community" perspective and input is INVALUABLE! Thank you all ------------------------------ Craig Hurwitz MD North...

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RE: Re: autonomic dysreflexia 1 day ago

Good morning and Happy New Year. I don't have much experience with vasodilators for AD other than topical nitroglycerine for acute presentations,...

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RE: Re: autonomic dysreflexia 1 day ago

Tough case. Curious concerning the cause of the spinal cord injury- was it thrombotic or inflammatory? Were any Anti-Aquaporin 4 antibodies sought?...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

With this degree of proteinuria genetic testing will be very, very low yield, in my opinion. I would select Obinutizumab and /or PLEX over ACTHAR g...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

I appreciate the input and agree that the fact he has remained dialysis dependent and has not had any response to multitargeted therapy is not a go...

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RE: Potassium Threshold For Op Management 1 day ago

Dr Soobadar: Appreciate the questions --Sometimes a CKD pt has asymptomatic hyperuricemia, say uric acid 8-10, and after I mention the possibilit...

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RE: Must Read 1 day ago

That was lovely. I also savoured reading the obituary in KI in November which looked at a slightly different but essentially the same, perspective ...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

Dialysis-dependent since June 2024, minimal urine output (SAlb improved because of oliguria/low GFR). Isn't renal recovery unlikely with any type o...

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Recurrent FSGS in Transplant 1 day ago

Dear all, I was hoping for help and advice regarding a young patient . For context I work in the UK. 30 year old male currently on Peri...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

I don't see any harm in trying ACTHAR , however I don't know if there is any data on minimal change pt on hd ( since you think minimal change is no...

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Re: autonomic dysreflexia 1 day ago

Good morning, Happy New Year to all. I am writing to discuss this patient with Autonomic Dysreflexia following total spinal cord infarction at...

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RE: Potassium Threshold For Op Management 1 day ago

Thanks prof Hirsch. What do you mean uric acid high patient does not want too take allopurinol? And high bun / creatine ratio ? -----------------...

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RE: (another) Refractory Minimal Change Disease (Dialysis dependent and I promised patient I would submit) 1 day ago

Thanks for the Post - a patient like this one with multi-drug resistance , severe NS and an initial kidney biopsy showing "Minimal Change Disease" ...

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